Healthcare
StartupYuzu closes new health partnerships in hours with Stedi
Yuzu Health is a Third-Party Administrator (TPA) that operates and manages health insurance plans on behalf of employers. TPAs act as the source of truth, ensuring that every claim and payment is accurately tracked for compliance. Unlike most existing TPAs, Yuzu is designed to handle the complexity of the modern fractured health insurance ecosystem.
Yuzu allows plan designers to craft consumer-centric plans quickly and with confidence. In the Yuzu app, employees and their trusted care guardians can review every aspect of their coverage, receive personalized provider recommendations, and track claims through each stage of the adjudication process.
Challenge
Partners in the health plan ecosystem typically exchange X12 EDI 834 Benefit Enrollment and Maintenance, 837 Post-Adjudicated Claims Data Reporting, and other related files. To provide a breadth of options for plan designers, Yuzu needed an EDI solution to help them quickly integrate with multiple partners.Yuzu also needed a HIPAA-eligible platform with best-in-class data security protocols and standards. This is critical to ensure that sensitive patient data and protected health information (PHI) remain safe and confidential.
Finally, Yuzu wanted expert guidance in navigating the complexity associated with EDI integrations. When evaluating available options, Yuzu co-founder Russell Pekala says Stedi’s comprehensive onboarding support stood out: “The Stedi team are EDI thought leaders, and they really took the time to educate us while we were getting started.”
Solution
Yuzu built EDI integrations with five healthcare partners using Stedi and plans to continue expanding to more partners in the coming months.
Once Stedi successfully processes an inbound healthcare claim, webhooks automatically send the status to Yuzu’s platform. This allows Yuzu to provide customers with consistent and accurate updates in real-time. Yuzu also uses Stedi webhooks to send errors to Slack, enabling the team to start resolving issues immediately.
For more details, check out Pam's post on the Yuzu blog. It dives deep into how her team used Stedi and Typescript to solve the many challenges and frustrations inherent in working with the EDI format.
Results
With Stedi, Yuzu can customize EDI guides, establish an FTP connection, and demonstrate automatic file processing, all on the first call with new partners. This has allowed them to close new partnerships within hours and build out successful integrations in days.
These capabilities have also made integrations significantly more cost-efficient. Pekala says, “Many potential partners were initially hesitant to integrate with a new TPA given the typical costs associated with building an EDI integration. Once we show them the EDI capabilities we built with Stedi, this is no longer an issue. We’ve been able to cut implementation fees with some partners by five-figure amounts because we can generate valid data so quickly.”
